Aortic aneurysms are often called “a silent killer,” because many people are not aware they have them until the aneurysms tear or rupture, often resulting in death.
That was apparently the case with journalist Grant Wahl, 49, who collapsed in his seat Friday while covering the world cup quarterfinal match between Argentina and the Netherlands in Lusail, Qatar.
Wahl’s wife, Céline Gounder, a physician, said that an autopsy confirmed that her husband died “from the rupture of a slowly growing, undetected ascending aortic aneurysm.”
The condition “is just one of those things that had been likely brewing for years,” Gounder said. “For whatever reason, it happened at this point in time.”
The Washington Post spoke to experts about aortic aneurysms — about who is at risk, whether they can be detected through screening and how they are treated. Here’s what they had to say.
What is an aortic aneurysm?
An aortic aneurysm is a balloon-type bulge in the aorta that can weaken one or all of the layers of the aortic wall, causing a dissection or rupture that “can have major catastrophic consequence,” said Milind Desai, medical director at the Center for Aortic Diseases at the Cleveland Clinic.
The aorta is the large blood vessel that carries blood from the heart through the chest and torso to the rest of the body. It has three layers, enabling it to withstand a lot of pressure.
But because of genetics and certain medical conditions, some people may be predisposed to dilation, which can grow into an aortic aneurysm, Desai said. When the aneurysm tears or ruptures, it can cause life-threatening bleeding.
What are the symptoms?
The vast majority of aortic aneurysms are asymptomatic, meaning they don’t cause any symptoms unless there is a dissection or a rupture. A dissection is a tear that occurs in the inner layer of the aorta, causing blood to leak out into the wall of the aorta.
“That’s the frustrating thing,” said Ahmet Kilic, a cardiac surgeon at Johns Hopkins University. “You can have an aneurysm with no symptoms.”
In some cases, depending on the location of the aneurysm on the artery and its size, there may be a few symptoms caused by the bulging vessel, according to the National institute of health. Those symptoms could include difficulty swallowing or breathing; feeling full; hoarseness in your voice; pain in the neck, jaw, back, chest, stomach or shoulder; a throbbing in your stomach; shortness of breath; and the swelling of your face, neck or arms.
Symptoms of a rupture — in which there is a tear through all three layers of the aortic wall —may include lightheadedness, a rapid heart rate and sudden severe pain in your stomach, chest or back.
If you develop symptoms, “you should seek immediate medical attention, because time is of the essence,” Kilic said.
Are aneurysms always fatal? Is there treatment?
When aneurysms are caught and treated early, they can be repaired, Desai said.
Small aneurysms “may be managed with healthy lifestyle changes,” such as heart-healthly. eating, physical activity and managing stress, according to NIH. Any treatments are intended to prevent the growth of an aneurysm, lowering the chance of an artery tearing or rupturing. So your doctor may focus on treating other medical conditions, such as high blood pressure, coronary heart disease, chronic kidney disease or high blood cholesterol, to reduce your risk, as well.
Once an aortic aneurysm is diagnosed, Desai said, the most important step is reducing stress on the aorta by lowering blood pressure and the heart rate, often with medications such as beta blockers.
In addition, he said, physicians warn these patients to avoid certain types of physical activity, such as intense weightlifting, that puts too much pressure on the aorta, and encourage patients to control comorbidities, such as hypertension, obesity and diabetes, “because they go hand in hand.”
“All aneurysms are not fatal,” Kilic said. “I have followed patients for decades with an aneurysm that may never need surgery.”